title: Knee extensor muscle strength and index of renal function associated with an exercise capacity of 5 metabolic equivalents in male chronic heart failure patients with chronic kidney disease.
abstract: BACKGROUND
  The goal of the present study was to determine knee extensor muscle strength (KEMS) and degree of renal dysfunction associated with an exercise capacity of ≥5 metabolic equivalents (METs) in male chronic heart failure (CHF) patients with chronic kidney disease (CKD).
  
  
  METHODS
  In this cross-sectional study of 75 male CHF patients with CKD (65.3 ± 11.6 years), we measured clinical characteristics, peak [Formula: see text], estimated glomerular filtration rate (eGFR), and KEMS. Patients were divided into two groups by exercise capacity: ≥5 METs group (n = 41) and <5 METs group (n = 34). Cutoff values for KEMS and eGFR resulting in an exercise capacity of ≥5 METs were selected with ROC curves. Patients were divided into four groups according to cutoff values, and numbers of patients attaining an exercise capacity of ≥5 METs were compared between groups.
  
  
  RESULTS
  Age was significantly higher although eGFR, Hb, and KEMS were lower in the <5 METs versus ≥5 METs group (P < 0.001). Multiple logistic regression analysis revealed a positive significant relation between KEMS and eGFR and exercise capacity of ≥5 METs. Exercise capacity of ≥5 METs was associated with KEMS of approximately 1.69 Nm/kg and an eGFR of 45.7 mL/min/1.73 m(2). The number of patients attaining an exercise capacity of ≥5 METs in the patients who did not reach both cutoff values was significantly lower than that in any other patients (P < 0.001).
  
  
  CONCLUSIONS
  KEMS and eGFR may be useful indices for predicting attainment of exercise capacity of ≥5 METs in male CHF patients with CKD.
authors.affiliation: Department of Rehabilitation Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Hotta
authors.forename: Koji
authors.initials: K
authors.lastname: Hiraki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kazuhiro P
authors.initials: KP
authors.lastname: Izawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Naohiko
authors.initials: N
authors.lastname: Osada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Omiya
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D017079:Exercise Tolerance; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D055686:Metabolic Equivalent; D008875:Middle Aged; D053580:Muscle Strength; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology